tbuckley/cabot-search huggingface dataset:
Racial and Ethnic Disparities in Glycemic Control Among Insured US Adults
Authors: Nora I. Zakaria, Parisa Tehranifar, Blandine Laferrère, Sandra S. Albrecht
Journal: JAMA Network Open (2023)

Importance Poor access to care and lack of health insurance are important contributors to disparities in glycemic control. However expanding health insurance coverage may not be enough to fully address the high burden of poor glycemic control for some groups. Objective To characterize racial and ethnic disparities in glycemic control among adults with private and public insurance in the US over a 15-year timeframe and to evaluate whether social, health care, and behavioral or health status factors attenuate estimates of disparities. Design, Setting, and Participants This cross-sectional study used data from the National Health and Nutrition Examination Survey from 2003 to 2018. Participants included Hispanic or Latino, non-Hispanic Black, and non-Hispanic White adults aged 25 to 80 years with self-reported diabetes and health insurance. Data were analyzed from January 15 to August 23, 2023. Exposure Participants self-identified as Hispanic or Latino, non-Hispanic Black, or non-Hispanic White. Main Outcomes and Measures The main outcome, poor glycemic control, was defined as glycated hemoglobin A 1c (HbA 1c ) of 7.0% or greater. Information about social (education, food security, and nativity), health care (insurance type, routine place for health care, insurance gap in past year, and use of diabetes medications), and behavioral or health status (years with diabetes, waist circumference, and smoking) factors were collected via questionnaires. Results A total of 4070 individuals (weighted mean [SE] age, 61.4 [0.27] years; 1970 [weighted proportion, 49.3%] were women) were included, representing 16 337 362 US adults, including 1146 Hispanic or Latino individuals (weighted proportion, 13.2%), 1196 non-Hispanic Black individuals (weighted proportion, 15.7%), and 1728 non-Hispanic White individuals (weighted proportion, 71.1%). In models adjusted for age, sex, and survey year, Hispanic or Latino and non-Hispanic Black individuals had significantly higher odds of poor glycemic control than non-Hispanic White individuals (Hispanic or Latino: odds ratio [OR], 1.46; 95% CI, 1.16-1.83; Black: OR, 1.28; 95% CI, 1.04-1.57). There was some attenuation after adjustment for social factors, especially food security (Hispanic or Latino: OR, 1.39; 95% CI, 1.08-1.81); Black: OR, 1.39; 95% CI, 1.08-1.81). However, accounting for health care and behavioral or health status factors increased disparities, especially for Hispanic or Latino individuals (OR, 1.63; 95% CI, 1.24-2.16), with racial and ethnic disparities persisting even among those with private insurance (OR, 1.66; 95% CI, 1.10-2.52). Conclusions and Relevance In this cross-sectional study of insured adults with diabetes in the US, disparities in poor glycemic control persisted despite adjustment for social, health care, and behavioral factors. Research is needed to identify the barriers contributing to poor control even in populations with access to care.
Syphilis Mimicking Malignant Pulmonary Tumor With Nodal and Bone Metastasis on 18F-FDG PET/CT
Authors: Angela Bronte Viedma, Sandra Menendez-Sanchez, Juan Fernando Bastidas Tamayo, Héctor Lajusticia Andrés, Maria José García-Velloso
Journal: Clinical Nuclear Medicine (2023)

A 52-year-old man suffering left pleuritic pain underwent a chest CT showing a subpleural pulmonary nodule in the left upper lobe. Because of the possibility of a lung tumor, he was referred for 18 F-FDG PET/CT. The scan revealed FDG uptake in the pulmonary nodule, in an upper right paratracheal lymph node, and at 4 destructive bone lesions. Pathologic examination after pulmonary biopsy manifested only the presence of inflammatory cells. Further clinical history research proved risky sexual behavior with a positive syphilis serology test. A follow-up PET/CT 7 months after penicillin therapy showed a complete metabolic response of all the lesions.
Levels of Physical Activity at Age 10 Years and Brain Morphology Changes From Ages 10 to 14 Years
Authors: Fernando Estévez-López, Lorenza Dall’Aglio, María Rodriguez-Ayllon, Bing Xu, Yueyue You, Charles H. Hillman, Ryan L. Muetzel, Henning Tiemeier
Journal: JAMA Network Open (2023)

Physical activity may promote healthy brain development in children, but previous research was predominantly cross-sectional and included small samples, providing limited knowledge.To investigate the longitudinal associations of physical activity with brain morphology changes.A 4-year longitudinal population-based cohort study in Rotterdam, the Netherlands, embedded in Generation R, a cohort from fetal life onward. From the women enrolled during pregnancy, children who had repeated measures of brain structure at ages 10 (range 8 to 12) years and 14 (range 13 to 15) years were included. Data were collected from March 2013 to November 2015 (baseline) and from October 2016 to January 2020 (follow-up). Data were analyzed from April to December 2022.At age 10 years, both the child and their primary caregiver reported the child's levels of physical activity with regard to sport participation, outdoor play, and total physical activity. Primary analyses were based on an average multi-informant report.Brain morphology was quantified by magnetic resonance imaging. Hypothesized regions of interest were the bilateral amygdala and hippocampal volumes. Global brain measures were studied to test the specificity of the hypothesis.Data were available for 1088 children (566 girls [52%]; 693 [64%] Dutch). Their mean (SD) age at baseline was 10.1 (0.6) years. For amygdala volume change, positive associations with multi-informant reports of total physical activity (β = 2.6; 95% CI, 0.3-4.9) were found. Total physical activity was associated with hippocampal volume increases only when reported by the child (β = 3.1; 95% CI, 0.4-5.8). No robust associations with global brain measures were found.In this cohort study of 1088 children, more physical activity at 10 years was consistently associated with an increase in amygdala volume in children aged 10 to 14 years. Physical activity and increases in hippocampal volume were found using child reports of physical activity only. These findings suggest physical activity in late childhood was prospectively associated with volumetric changes in specific subcortical structures, but not to global brain development, from late childhood to early adolescence. These findings may inform the design of future public health interventions to best facilitate neurodevelopment with physical activity.
Risk of liver-related events in metabolic dysfunction–associated steatohepatitis (MASH) patients with fibrosis: A comparative analysis of various risk stratification criteria
Authors: Grazia Pennisi, Marco Enea, Manuel Romero-Gomez, Elisabetta Bugianesi, Vincent Wai-Sun Wong, Anna Ludovica Fracanzani, Victor de Ledinghen, Jacob George, Annalisa Berzigotti, Mauro Viganò, Giada Sebastiani, Roberto Cannella, Adèle Delamarre, Gabriele Di Maria, Naomi F. Lange, Adele Tulone, Vito Di Marco, Calogero Cammà, Salvatore Petta
Journal: Hepatology (2023)

Background and Aims: International regulatory agencies recommend testing drug therapy for patients with noncirrhotic high-risk metabolic dysfunction–associated steatohepatitis (MASH) because they are at risk of liver-related events (LRE). We aimed to compare the risk of LRE in patients with MASLD stratified for F2-F4 fibrosis and MASH. Approach and Results: Overall, 1938 consecutive patients with biopsy-proven MASLD were enrolled. High-risk MASH was defined as MASH with F2-F4 fibrosis. LSM was measured by transient elastography. LRE were recorded during follow-up. Cox multivariate models were used to assess the association between high-risk MASH or F2-F4 fibrosis without MASH, of LSM (≥8 or ≥10 Kpa), and of AGILE 3+ with LRE. The diagnostic performance for the prediction of LRE was assessed using the area under the receiver operating characteristic curves. The observed 5-year actuarial rate of LRE was 0.4%, 0.2%, 5.1%, and 6.6% in patients with F0-F1 fibrosis without MASH, F0-F1 fibrosis with MASH, F2-F4 fibrosis without MASH, and high-risk MASH, respectively. At multivariate Cox regression analysis using F0-F1 fibrosis without MASH as a reference, both F2-F4 fibrosis without MASH [adjusted HR (aHR) 9.96] and high-risk MASH (aHR 10.14) were associated with LRE. In the 1074 patients with available LSM, LSM ≥ 10 kPa (aHR 6.31) or AGILE 3+ &gt; 0.67 (aHR 27.45) independently predicted the development of LRE and had similarly acceptable 5-year area under the receiver operating characteristic to high-risk MASH and F2-F4 fibrosis (0.772, 0.818, 0.739, and 0.780, respectively). Conclusions: The risk of LRE is similar in patients with high-risk MASH and with F2-F4 fibrosis without MASH. The use of LSM ≥ 10 kPa or AGILE 3+ &gt; 0.67 could be an accurate option to identify patients with MASLD worthy to be included in clinical trials.
Seed Becoming Soil: A New Paradigm of the Ewing Sarcoma Tumor Microenvironment
Authors: Christopher Kuo, James F. Amatruda
Journal: Clinical Cancer Research (2023)

Summary Cells in the tumor microenvironment, including cancer-associated fibroblasts (CAF), contribute to tumor growth and immune evasion. A recent study of Ewing sarcoma identified “CAF-like” tumor cells that mimic the protumorigenic features of CAFs. These findings highlight the role of cell plasticity in tumor growth. See related article by Wrenn et al., p. 5140
Changes in Cannabis-Attributable Hospitalizations Following Nonmedical Cannabis Legalization in Canada
Authors: Daniel T. Myran, Adrienne Gaudreault, Lauren Konikoff, Robert Talarico, Rosalie Liccardo Pacula
Journal: JAMA Network Open (2023)

Importance The impact of adult-use cannabis legalization and subsequent commercialization (ie, increasing store and product access) on hospitalizations in Canada is unclear. Objectives To examine changes in overall and subtypes of hospitalizations due to cannabis and associated factors following legalization in Canada and to compare changes between provinces. Design, Setting, and Participants This repeated cross-sectional analysis included all acute hospitalizations for individuals aged 15 to 105 years in Canada’s 4 most populous provinces (Ontario, Quebec, Alberta and British Columbia, population 26.9 million individuals in 2018). Data were obtained from routinely collected health administrative databases. Immediate and gradual changes in the age- and sex-standardized rates of hospitalizations due to cannabis were compared using an interrupted time series design over 3 time periods: prelegalization (January 2015 to September 2018), legalization with product and store restrictions (October 2018 to February 2020), and commercialization, which overlapped with the COVID-19 pandemic (March 2020 to March 2021). Main Outcomes and Measures Rates of hospitalizations due to cannabis per 100 000 individuals and per 1000 all-cause hospital admissions. Results There were 105 203 hospitalizations due to cannabis over the 7-year study period, 69 192 of which (65.8%) were among male individuals, and 34 678 (33%) of which were among individuals aged 15 to 24 years. Overall, the age- and sex-standardized rate of hospitalizations increased 1.62 times between January 2015 (3.99 per 100 000 individuals) and March 2021 (6.46 per 100 000 individuals). The largest relative increase in hospitalizations was for cannabis-induced psychosis (rate ratio, 1.40; 95% CI, 1.34 to 1.47 during the commercialization period relative to the prelegalization period). Nationally, legalization with restrictions was associated with a gradual monthly decrease of −0.06 (95% CI −0.08 to −0.03) in hospitalizations due to cannabis per 100 000 individuals. Commercialization and the COVID-19 pandemic were associated with an immediate increase of 0.83 (95% CI, 0.30 to 1.30) hospitalizations due to cannabis per 100 000 individuals. There was provincial variation in changes, with provinces with less mature legal markets experiencing the greatest declines immediately following legalization. Conclusions and Relevance This cross-sectional study found that legalization with restrictions was not associated with an increase in hospitalizations due to cannabis but commercialization was. The findings suggest that commercialization of cannabis may be associated with increases in cannabis-related health harms, including cannabis-induced psychosis.
A False-Positive Bone Oligometastatic Prostate Cancer in 18F-Choline PET/CT
Authors: Valentin Pretet, Aurélie Moreau, Louis Larrouquere, Thomas Mognetti, David Kryza
Journal: Clinical Nuclear Medicine (2023)

We report the case of a 71-year-old man undergoing initial assessment for a high-risk group prostate adenocarcinoma. His medical history includes gastric carcinoma treated with surgery and chemotherapy. 18 F-choline PET/CT was performed for initial staging and displayed several intense foci uptake of sternum and thoracic vertebrae, suggestive of bone metastasis. Because of a chronic right jugulosubclavian confluent thrombosis related to his implantable chamber, a control was performed 3 weeks later. It showed spontaneous disappearance of those uptakes, consistent with pitfalls related to the collateral circulation induced by the chronic right subclavian vein thrombosis, despite the chronic anticoagulation.
The Chronic Obstructive Pulmonary Disease (COPD)–Bronchiectasis Overlap Syndrome: Does My COPD Patient Have Bronchiectasis on Computed Tomography? “Frankly, My Dear, I Don’t Give a Damn!”
Authors: Mark L. Metersky, Mark T. Dransfield
Journal: American Journal of Respiratory and Critical Care Medicine (2023)

"The COPD-Bronchiectasis Overlap Syndrome: Does My COPD Patient Have Bronchiectasis on CT? Frankly, My Dear, I Don’t Give a Damn! ." American Journal of Respiratory and Critical Care Medicine, 0(ja), pp.
TCR ligand potency differentially impacts PD-1 inhibitory effects on diverse signaling pathways
Authors: Waipan Chan, Yuqi M. Cao, Xiang Zhao, Edward C. Schrom, Dongya Jia, Jian Song, Leah V. Sibener, Shen Dong, Ricardo A. Fernandes, Clinton J. Bradfield, Margery Smelkinson, Juraj Kabat, Jyh Liang Hor, Grégoire Altan-Bonnet, K. Christopher Garcia, Ronald N. Germain
Journal: The Journal of Experimental Medicine (2023)

Checkpoint blockade revolutionized cancer therapy, but we still lack a quantitative, mechanistic understanding of how inhibitory receptors affect diverse signaling pathways. To address this issue, we developed and applied a fluorescent intracellular live multiplex signal transduction activity reporter (FILMSTAR) system to analyze PD-1-induced suppressive effects. These studies identified pathways triggered solely by TCR or requiring both TCR and CD28 inputs. Using presenting cells differing in PD-L1 and CD80 expression while displaying TCR ligands of distinct potency, we found that PD-1-mediated inhibition primarily targets TCR-linked signals in a manner highly sensitive to peptide ligand quality. These findings help resolve discrepancies in existing data about the site(s) of PD-1 inhibition in T cells while emphasizing the importance of neoantigen potency in controlling the effects of checkpoint therapy.
Association of Breast Density With Risk of Breast Cancer—Reply
Authors: Shu Jiang, Graham A. Colditz
Journal: JAMA Oncology (2023)

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Simulation‐Assisted DNA Nanodevice Serve as a General Optical Platform for Multiplexed Analysis of Micrornas
Authors: Xiao‐Qiong Li, Yi‐Lei Jia, Yu‐Wen Zhang, Peng‐Fei Shi, Hong‐Yuan Chen, Jing‐Juan Xu
Journal: Advanced Healthcare Materials (2023)

Abstract Small frame nucleic acids (FNAs) serve as excellent carrier materials for various functional nucleic acid molecules, showcasing extensive potential applications in biomedicine development. The carrier module and function module combination is crucial for probe design, where an improper combination can significantly impede the functionality of sensing platforms. This study explores the effect of various combinations on the sensing performance of nanodevices through simulations and experimental approaches. Variances in response velocities, sensitivities, and cell uptake efficiencies across different structures are observed. Factors such as the number of functional molecules loaded, loading positions, and intermodular distances affect the rigidity and stability of the nanostructure. The findings reveal that the structures with full loads and moderate distances between modules have the lowest potential energy. Based on these insights, a multisignal detection platform that offers optimal sensitivity and response speed is developed. This research offers valuable insights for designing FNAs‐based probes and presents a streamlined method for the conceptualization and optimization of DNA nanodevices.
Safety of continuing mineralocorticoid receptor antagonist treatment in patients with heart failure with reduced ejection fraction and severe kidney disease: Data from Swedish Heart Failure Registry
Authors: Federica Guidetti, Lars H. Lund, Lina Benson, Camilla Hage, Francesca Musella, Davide Stolfo, Peter G.M. Mol, Andreas J. Flammer, Frank Ruschitzka, Ulf Dahlstrom, Giuseppe M.C. Rosano, Oscar Ö. Braun, Gianluigi Savarese
Journal: European Journal of Heart Failure (2023)

ABSTRACT Aims Mineralocorticoid receptor antagonists (MRAs) improve outcomes in heart failure with reduced ejection fraction (HFrEF) but remain underused and are often discontinued especially in patients with chronic kidney disease (CKD) due to concerns on renal safety. Therefore, in a real‐world HFrEF population we investigated the safety of MRA use, in terms of risk of renal events, any mortality and any hospitalization, across the estimated glomerular filtration rate (eGFR) spectrum including severe CKD. Methods and results We analysed patients with HFrEF (ejection fraction &lt;40%), not on dialysis, from the Swedish Heart Failure Registry. We performed multivariable logistic regression models to investigate patient characteristics independently associated with MRA use, and univariable and multivariable Cox regression models to assess the associations between MRA use and outcomes. Of 33 942 patients, 17 489 (51%) received MRA, 32%, 45%, 54%, 54% with eGFR &lt;30, 30–44, 45–59 or ≥60 ml/min/1.73 m 2 , respectively. An eGFR ≥60 ml/min/1.73 m 2 and patient characteristics linked with more severe HF were independently associated with more likely MRA use. In multivariable analyses, MRA use was consistently not associated with a higher risk of renal events (i.e. composite of dialysis/renal death/hospitalization for renal failure or hyperkalaemia) (hazard ratio [HR] 1.04, 95% confidence interval [CI] 0.98–1.10), all‐cause death (HR 1.02, 95% CI 0.97–1.08) as well as of all‐cause hospitalization (HR 0.99, 95% CI 0.95–1.02) across the eGFR spectrum including also severe CKD. Conclusions The use of MRAs in patients with HFrEF decreased with worse renal function; however their safety profile was demonstrated to be consistent across the entire eGFR spectrum.
Liquid Biopsies in Breast Milk for the Early Detection of Breast Cancer
Authors: Niamh Cunningham, Nicholas C Turner
Journal: Cancer Discovery (2023)

Summary: Cell-free tumor DNA has previously been detected in nonblood sources, including urine, saliva, stool, cerebrospinal fluid, and pleural fluid. In this issue, Saura and colleagues present a novel proof-of-concept study demonstrating that detection of tumor DNA in breast milk is feasible and may be a potential future strategy to screen for postpartum breast cancer. See related article by Saura et al., p. 2180 (14).
A 95% decline in estimated newly acquired HIV infections, Amsterdam, 2010 to 2022
Journal: Eurosurveillance (2023)

The infrastructure in cities provides unique opportunities to eliminate HIV. Since 2014, the HIV Transmission Elimination AMsterdam Initiative, a consortium involved in HIV prevention and care, has employed an integrated approach to curb HIV incidence in Amsterdam. This effort contributed to the 95% decline in estimated newly acquired infections and the 79% decline in observed new HIV diagnoses in Amsterdam from 2010 to 2022. In 2022, Amsterdam reached and exceeded the 95–95–95 UNAIDS treatment cascade goals (98–95%-96%).
Genomic approaches to explore susceptibility and pathogenesis of alcohol use disorder and alcohol-associated liver disease
Authors: Trina M. Norden-Krichmar, Daniel Rotroff, Tae-Hwi Schwantes-An, Ramon Bataller, David Goldman, Laura E. Nagy, Suthat Liangpunsakul
Journal: Hepatology (2023)

Excessive alcohol use is a major risk factor for the development of an alcohol use disorder (AUD) and contributes to a wide variety of other medical illnesses, including alcohol-associated liver disease (ALD). Both AUD and ALD are complex and causally interrelated diseases, and multiple factors other than alcohol consumption are implicated in the disease pathogenesis. While the underlying pathophysiology of AUD and ALD is complex, there is substantial evidence for a genetic susceptibility of both diseases. Current genome-wide association studies indicate that the genes associated with clinical AUD only poorly overlap with the genes identified for heavy drinking and, in turn, neither overlap with the genes identified for ALD. Uncovering the main genetic factors will enable us to identify molecular drivers underlying the pathogenesis, discover potential targets for therapy, and implement patient care early in disease progression. In this review, we described multiple genomic approaches and their implications to investigate the susceptibility and pathogenesis of both AUD and ALD. We concluded our review with a discussion of the knowledge gaps and future research on genomic studies in these 2 diseases.
A New Paradigm of the Origins of Circulating DNA in Patients with Cancer
Authors: Alain R. Thierry, Ekaterina Pisareva
Journal: Cancer Discovery (2023)

Summary: By shedding light on the cellular origins of circulating DNA (cirDNA), this research provides important insights into the mechanisms of cirDNA production in cancer. Contrary to expectations, the increased cirDNA in patients with cancer was not derived predominantly from neoplastic cells or surrounding nonneoplastic epithelial cells; rather, the excess cirDNA originated primarily from leukocytes, implying a systemic impact of cancer on cell turnover or DNA clearance. See related article by Mattox et al., p. 2166 (1).